Evaluation of diagnosis and treatment results in children with Graves' disease with emphasis on the pubertal status of patients.

This retrospective study evaluated the clinical and laboratory characteristics at presentation and treatment results of patients with Graves' disease (GD) with respect to pubertal status. Records of 143 patients (108 F, 35 M) were reviewed in a multicenter study. At diagnosis, 38% of patients were prepubertal. Anti-thyroid drugs (ATD) were used as initial therapy. There was no significant difference in clinical and laboratory characteristics at diagnosis, during treatment and adverse reaction to ATD with respect to pubertal status. Twenty patients (7 prepubertal, 13 pubertal) reached remission on ATD. Surgery was performed in seven and radioiodine (RAI) in four patients. Duration of treatment needed to achieve remission was longer in prepubertal (4.2 +/- 1.0 yr) than in pubertal patients (3.1 +/- 1.3 yr) (p = 0.02). The rate of remission was not different between prepubertal (25.9%) and pubertal patients (33.3%) (p = 0.59). ATD were associated with low remission rate in pediatric GD and required longer duration of therapy in prepubertal patients. For definitive treatment in older children, RAI could be evaluated as the initial therapy.

Self-efficacy and its interrelation with family environment and metabolic control in Turkish adolescents with type 1 diabetes.

OBJECTIVE: To explore the relationship between self-efficacy, family environment (cohesion and organization) and metabolic control. RESEARCH DESIGN AND METHODS: A total of 100 adolescents with diabetes were assessed on a single occasion. Eligibility criteria were an age range of 11-18 yr, diagnosis of type 1 diabetes of at least 1 yr duration, and ability to complete the questionnaire unaided. Adolescents completed self-efficacy and family environment questionnaires. Metabolic control was assessed by HbA1c. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 10.0. Independent paired t-tests and Pearson's correlation coefficient were used as test methods. RESULTS: Boys and girls were comparable on self-efficacy, and self-efficacy scores were quite satisfactory for both boys and girls. There was a significant positive correlation between self-efficacy and family cohesion in girls, but self-efficacy was not related to the family environment (cohesion and organization) and metabolic control in the total sample. CONCLUSION: In the present study, there was no relationship between self-efficacy, family environment, and metabolic control in the total sample, but in girls, self-efficacy and family cohesion was positively correlated.